Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Correlation of contrast sensitivity with ganglion cell/inner plexiform layer thickness and damage location in glaucoma with varying severity

Eye (2023)Cite this article

Subjects

Abstract

Objectives

To investigate the correlation of contrast sensitivity with macular region ganglion cell/inner plexiform layer (GC/IPL) thickness and damage location in open-angle glaucoma (OAG) of varying severity.

Methods

Cross-sectional study with 106 patients (203 eyes) who had OAG. Contrast sensitivity of each eye evaluated by quick contrast sensitivity function test based on intelligent algorithm. The GC/IPL thickness measured with optical coherence tomography; six sectors were delineated for localization of damage area. All eyes were grouped by the healthy macular sector and divided into pre-perimetric, early, moderate, and advanced stages, according to severity of visual field impairment.

Results

Mean GC/IPL thickness in the entire macular region and each sector were correlated with parameters that reflected contrast sensitivity (p < 0.01). The structure-function correlations were stronger nasally compared with temporally, and superiorly compared with inferiorly. Eyes with normal structure in inferior temporal sector had less visual field (p' = 0.024) and macular damage (p′ = 0.034) compared with eyes that had healthy superior nasal sector; there was no difference in contrast sensitivity (p = 0.898). The structure-function correlations were significant in early, moderate, and advanced glaucoma (p < 0.05) but not in pre-perimetric glaucoma (p = 0.116).

Conclusions

GC/IPL thinning in all sectors of the macular region in OAG was correlated with contrast sensitivity impairment, whereas the inferior temporal sector was least affected. Contrast sensitivity was supported as a severity evaluation indicator of early, moderate, and advanced glaucoma, but not of pre-perimetric glaucoma.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: The distribution of ganglion cell/internal plexiform layer (GC/IPL) thickness and the grouping principle for three different eyes.
Fig. 2: Comparison between groups of mean deviation (MD), the area under log [CSF] (AULCSF), and ganglion cell / internal plexiform layer (GC/IPL).

Similar content being viewed by others

Data availability

All data generated or analyzed during this study are included in this published article and its supplementary information files.

References

  1. Ginsburg AP. Contrast sensitivity and functional vision. Int Ophthalmol Clin. 2003;43:5–15.

    Article  PubMed  Google Scholar 

  2. Thompson AC, Chen H, Miller ME, Webb CC, Williamson JD, Marsh AP, et al. Association between contrast sensitivity and physical function in cognitively healthy older adults: the brain network and mobility function study. J Gerontol A Biol Sci Med Sci 2023;78:1513–21.

    Article  PubMed  Google Scholar 

  3. Hu CX, Zangalli C, Hsieh M, Gupta L, Williams AL, Richman J, et al. What do patients with glaucoma see? Visual symptoms reported by patients with glaucoma. Am J Med Sci. 2014;348:403–9.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Eshraghi H, Sanvicente CT, Gogte P, Waisbourd M, Lee D, Manzi RRS, et al. Measuring contrast sensitivity in specific areas of vision - a meaningful way to assess quality of life and ability to perform daily activities in glaucoma. Ophthalmic Epidemiol. 2019;26:301–10.

    Article  PubMed  Google Scholar 

  5. Lin S, Mihailovic A, West SK, Johnson CA, Friedman DS, Kong X, et al. Predicting visual disability in glaucoma with combinations of vision measures. Transl Vis Sci Technol. 2018;7:22.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Enoch J, Jones L, Taylor DJ, Bronze C, Kirwan JF, Jones PR, et al. How do different lighting conditions affect the vision and quality of life of people with glaucoma? A systematic review. Eye. 2020;34:138–54.

    Article  PubMed  Google Scholar 

  7. Ichhpujani P, Thakur S, Spaeth GL. Contrast sensitivity and glaucoma. J Glaucoma. 2020;29:71–5.

    Article  PubMed  Google Scholar 

  8. Fatehi N, Nowroozizadeh S, Henry S, Coleman AL, Caprioli J, Nouri-Mahdavi K. Association of structural and functional measures with contrast sensitivity in glaucoma. Am J Ophthalmol. 2017;178:129–39.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Chien L, Liu R, Girkin C, Kwon M. Higher Contrast requirement for letter recognition and macular RGC+ layer thinning in glaucoma patients and older adults. Invest Ophthalmol Vis Sci. 2017;58:6221–31.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Shamsi F, Liu R, Owsley C, Kwon M. Identifying the retinal layers linked to human contrast sensitivity via deep learning. Invest Ophthalmol Vis Sci. 2022;63:27.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Xian Y, Sun L, Ye Y, Zhang X, Zhao W, Shen Y, et al. The characteristics of quick contrast sensitivity function in keratoconus and its correlation with corneal topography. Ophthalmol Ther. 2023;12:293–305.

    Article  PubMed  Google Scholar 

  12. Ou WC, Lesmes LA, Christie AH, Denlar RA, Csaky KG. Normal- and low-luminance automated quantitative contrast sensitivity assessment in eyes with age-related macular degeneration. Am J Ophthalmol. 2021;226:148–55.

    Article  PubMed  Google Scholar 

  13. Joltikov KA, de Castro VM, Davila JR, Anand R, Khan SM, Farbman N, et al. Multidimensional functional and structural evaluation reveals neuroretinal impairment in early diabetic retinopathy. Invest Ophthalmol Vis Sci. 2017;58:BIO277–90.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Joltikov KA, Sesi CA, de Castro VM, Davila JR, Anand R, Khan SM, et al. Disorganization of retinal inner layers (DRIL) and neuroretinal dysfunction in early diabetic retinopathy. Invest Ophthalmol Vis Sci. 2018;59:5481–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Joshi P, Dangwal A, Guleria I, Kothari S, Singh P, Kalra JM, et al. Glaucoma in adults-diagnosis, management, and prediagnosis to end-stage, categorizing glaucoma’s stages: a review. J Curr Glaucoma Pr. 2022;16:170–8.

    Google Scholar 

  16. Lesmes LA, Lu ZL, Baek J, Albright TD. Bayesian adaptive estimation of the contrast sensitivity function: the quick CSF method. J Vis. 2010;10:17.1–21.

    Article  PubMed  Google Scholar 

  17. Zheng H, Wang C, Cui R, He X, Shen M, Lesmes LA, et al. Measuring the contrast sensitivity function using the qCSF method with 10 digits. Transl Vis Sci Technol. 2018;7:9.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Kelly DH. Spatial frequency selectivity in the retina. Vis Res. 1975;15:665–72.

    Article  CAS  PubMed  Google Scholar 

  19. Enroth-Cugell C, Robson JG. The contrast sensitivity of retinal ganglion cells of the cat. J Physiol. 1966;187:517–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Pang R, Peng J, Cao K, Sun Y, Pei XT, Yang D, et al. Association between contrast sensitivity function and structural damage in primary open-angle glaucoma. Br J Ophthalmol. 2023. https://doi.org/10.1136/bjo-2023-323539. Epub ahead of print.

  21. Elliott DB. Evaluating visual function in cataract. Optom Vis Sci. 1993;70:896–902.

    Article  CAS  PubMed  Google Scholar 

  22. Perry VH, Cowey A. The ganglion cell and cone distributions in the monkey’s retina: implications for central magnification factors. Vis Res. 1985;25:1795–810.

    Article  CAS  PubMed  Google Scholar 

  23. Curcio CA, Allen KA. Topography of ganglion cells in human retina. J Comp Neurol. 1990;300:5–25.

    Article  CAS  PubMed  Google Scholar 

  24. Sato S, Hirooka K, Baba T, Tenkumo K, Nitta E, Shiraga F. Correlation between the ganglion cell-inner plexiform layer thickness measured with cirrus HD-OCT and macular visual field sensitivity measured with microperimetry. Invest Ophthalmol Vis Sci. 2013;54:3046–51.

    Article  PubMed  Google Scholar 

  25. Ghita AM, Iliescu DA, Ghita AC, Ilie LA, Otobic A. Ganglion cell complex analysis: correlations with retinal nerve fiber layer on optical coherence tomography. Diagnostics. 2023;13:266.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kim KE, Park KH. Macular imaging by optical coherence tomography in the diagnosis and management of glaucoma. Br J Ophthalmol. 2018;102:718–24.

    Article  PubMed  Google Scholar 

  27. Gao J, Provencio I, Liu X. Intrinsically photosensitive retinal ganglion cells in glaucoma. Front Cell Neurosci. 2022;16:992747.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. San Laureano J. When is glaucoma really glaucoma? Clin Exp Optom. 2007;90:376–85.

    Article  PubMed  Google Scholar 

  29. de Moraes CG, Liebmann JM, Medeiros FA, Weinreb RN. Management of advanced glaucoma: Characterization and monitoring. Surv Ophthalmol. 2016;61:597–615.

    Article  PubMed  Google Scholar 

  30. Stamper RL, Hsu-Winges C, Sopher M. Arden contrast sensitivity testing in glaucoma. Arch Ophthalmol. 1982;100:947–50.

    Article  CAS  PubMed  Google Scholar 

  31. Richman J, Zangalli C, Lu L, Wizov SS, Spaeth E, Spaeth GL. The Spaeth/Richman contrast sensitivity test (SPARCS): design, reproducibility and ability to identify patients with glaucoma. Br J Ophthalmol. 2015;99:16–20.

    Article  PubMed  Google Scholar 

  32. Thakur S, Ichhpujani P, Kumar S, Kaur R, Sood S. Assessment of contrast sensitivity by Spaeth Richman Contrast Sensitivity Test and Pelli Robson Chart Test in patients with varying severity of glaucoma. Eye. 2018;32:1392–400.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Bierings R, de Boer MH, Jansonius NM. Visual performance as a function of luminance in glaucoma: The De Vries-Rose, Weber’s, and Ferry-Porter’s Law. Invest Ophthalmol Vis Sci. 2018;59:3416–23.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank AiMi Academic Services (www.aimieditor.com) for English language editing and review services.

Funding

The study is funded by National Natural Science Foundation of China (82130029 and 82070960). The funding organization had no role in the design or conduct of this research.

Author information

Author notes

  1. These authors contributed equally: Ruiqi Pang, Jieting Peng.

Authors and Affiliations

  1. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China

    Ruiqi Pang, Jieting Peng, Qing Zhang, Kai Cao & Ningli Wang

  2. Eye School, Chengdu University of traditional Chinese Medicine, Chengdu, China

    Jieting Peng

  3. Division of Arts and Sciences, NYU Shanghai, Shanghai, China

    Zhong-Lin Lu

  4. Center for Neural Science and Department of Psychology, New York University, New York, NY, USA

    Zhong-Lin Lu

  5. NYU-ECNU Institute of Brain and Cognitive Neuroscience, Shanghai, China

    Zhong-Lin Lu

Authors
  1. Ruiqi Pang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jieting Peng
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Qing Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kai Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Zhong-Lin Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ningli Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

NW contributed to design, acquisition of funding and general supervision of the research group. RP and JTP contributed to design, analysis of results, collection of data and drafting of the manuscript. KC contributed to the data analysis. ZLL and QZ contributed to the manuscript revision. All authors reviewed and edited the manuscript and approved the final version of the manuscript.

Corresponding author

Correspondence to Ningli Wang.

Ethics declarations

Competing interests

ZLL holds intellectual property interests in visual function measurement and rehabilitation technologies, and equity interests in Adaptive Sensory Technology, Inc. (San Diego, CA, USA) and Jiangsu Juehua Medical Technology, Ltd (Jiangsu, China). There is no other conflict of interest in the submission of this manuscript.

Ethics approval

The Medical Ethics Committee of Beijing Tongren Hospital approved all study procedures.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pang, R., Peng, J., Zhang, Q. et al. Correlation of contrast sensitivity with ganglion cell/inner plexiform layer thickness and damage location in glaucoma with varying severity. Eye (2023). https://doi.org/10.1038/s41433-023-02887-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1038/s41433-023-02887-0

Search

Advanced search

Quick links